I have not used any afflictions in my game as of yet, but the party will shortly be going through a festering bog, which if normal mosquitos don't give them a disease, the stirge or some other creature may.

Say they fail any related saving throws for the disease. Do the PC's somehow know they have the disease, or is it, understandably so, something they wouldn't notice unless there was a large sudden effect (looking at you blinding sickness)

If they PC's don't know, do you tell the players and hope they don't Meta, or do you hide it from them as well? And for the saving throws, do you roll them in secret, or have the players roll them as usual? I am just unsure of what to tell the players vs keep to myself, and what the PC would/should know.

  • \$\begingroup\$ You might take into account how debilitating the disease is and which options the PCs have to deal with it. You mentioned the blinding sickness for example. If I remember right it states the eyes falling out and the normal go to spell to cure blindness, remove blindness/deafness states: The spell does not restore ears or eyes that have been lost, but it repairs them if they are damaged So hinting that they have contracted something might be helpful in games that are not too gritty. \$\endgroup\$ – Umbranus Sep 1 '16 at 9:43

Simply put, you can't become aware that you are diseased by yourself.

They will know if they are feeling weaker, dizzy, confused, overwhelmed, annoyed than their usual selves, or if red dots start showing up all over their skin, or if their skin starts to peel off or fall apart (ew).

But even a Heal check cannot tell exactly what disease a character has, or even if he has a disease. The symptoms could really be anything from poison, to diseases, to curses, to magical effects (nightmares), to your GM being mean to you for not bringing him a beer.

As a GM, i simply try to roleplay the effects, describing how they feel. This one time we had a Magus character wearing a cursed bandana that caused -4 INT, and made him think he was the smartest guy alive, we all simply roleplayed as if he had +4 INT (the "disguised magic effect") and he acted as if that was true.

He, of course, didn't know it was cursed. I had a ton of work to manage his abilities and if his INT was actually 4 points lower instead of 4 points higher. And he only figured something was going on when spells that he had memorized using slots from that higher INT score started to fail. But that took him about 6 sessions to ask someone to cast identify on the bandana and find out about the curse.


Knowledge in a specific area that is related to treating diseases, such as Knowledge(Religion) to know that ghouls carry a disease, or Knowledge(Nature) to know that rats carry diseases, will allow you to possibly know what kind of disease might be affecting a character. But the exact DC and what kind of information is given is up to the GM, and will suffer table variations.


Like Knowledge, Profession, as long as it is related to the cause of the disease (herbalist? doctor?), could give you some information about what is going on. But again, the information and DC is entirely up to your GM and might not work at all.


The spell Diagnose Disease was written to solve your problems.

You determine whether a creature, object, or area carries any sort of disease or infestation (including molds, slimes, and similar hazards), or any exceptional or supernatural effects causing the sickened or nauseated effects. If there is disease present, you know what disease it is and its effects.

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    \$\begingroup\$ So with that example, do you mean even the players were not aware of the curse, or they were and just roleplayed well as though it were a normal item? I think I am going to implement a DC20 Heal check to determine that the PC is actually sick with no obvious symptoms (Your weakness is caused by a sickness, not just a poor nights sleep, etc) though various things can modify that. Once you know they have a sickness, or it progresses long enough to have obvious outward effects then you can use Heal to assist them. But otherwise what you've said is basically how I thought of it. \$\endgroup\$ – Omnitus Aug 31 '16 at 20:57
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    \$\begingroup\$ I want to try keeping them in the dark as much as possible. Thanks for your answer! \$\endgroup\$ – Omnitus Aug 31 '16 at 20:58
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    \$\begingroup\$ @Omnitus they had no idea the item was cursed. I did all the book keeping. \$\endgroup\$ – ShadowKras Aug 31 '16 at 21:21
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    \$\begingroup\$ A little more backstory, this character had 18 INT, and he thought he was at 22 INT now, when in fact his INT was 14. So i checked the difference between 22 and 14 (8 points) and applied that as a penalty to his INT related checks and abilities, his INT-based skills got a -4 penalty (i simply increased the DC and he told me his total), his "last" spell slots prepared using a high int bonus fizzled mysteriously (which is what prompted him that something was wrong), and his arcana pool was 4 points lower than he thought it was. \$\endgroup\$ – ShadowKras Aug 31 '16 at 21:24
  • \$\begingroup\$ archivesofnethys.com/… \$\endgroup\$ – ShadowKras Aug 31 '16 at 21:28

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